Some healthcare IT leaders call it the perfect storm: the buffeting crosswinds of increased regulatory quality reporting, ICD-10 implementation, and the shift to accountable care. Is it any wonder that CIOs and CMIOs are expecting more from their technology solution vendors and service providers?
At a time like this, providers are more focused than ever on making sure their technology investments are having a positive impact on the lives of their patients. The “2013 Best in KLAS Software and Services” report, which produces insights on vendor performance based on feedback from thousands of provider executives, nurses, doctors, technicians, office managers, etc., offers a timely snapshot of an industry in transition. Some vendors are rising to the challenge of meeting and even surpassing customer expectations, and taking on the role of partner rather than just supplier. For instance, athenahealth edged out Epic as the top Overall Software Vendor.
It is the first vendor to do so since 2008, the year KLAS began ranking an overall software leader. Although Epic was unseated by athenahealth for the spot of top Overall Software Vendor, it maintained the No.1 Overall Software Suite ranking. Also, as the industry changes, KLAS adds categories of performance to measure. In this year’s report, which has a streamlined look and feel, the Health Information Exchange and Patient Portal categories, which have been measured for performance in the past, are now eligible for Best in KLAS awards. In addition, with the ICD-10 deadline on the horizon, Computer-Assisted Coding was added as well.
What follows is a segment-by-segment look at some of the trends underlying the shifts in provider ratings of health IT products and services.
When it comes to choosing an EMR for the acute-care setting, health systems continue to focus on integration and continuity, with an eye on choosing a vendor partner to work with over the long term, says Colin Buckley, director of research strategy at KLAS.
Providers do not want to pay for lots of interfaces, which are going to be expensive, complex, and a distraction when they are trying to deal with more strategic issues such as accountable care, Buckley says. Getting ambulatory and inpatient systems talking to each other continues to be a major criterion. “Epic and Cerner have had the strongest integration story across the continuum of care. They continue to be the highest rated and continue to get the most new market share year after year” he says.
Other vendors in this space still have more work to do to achieve similar strength across their integrated portfolio, he notes. For instance, although Allscripts’ third-ranked EMR, Sunrise Clinical Manager, has an integrated ambulatory offering, the company’s focus has been to allow providers to choose different ambulatory systems based on their needs rather than forcing all customers to the fully integrated solution. To date, this has not played out as well in the market, but early customer fedback indicates that this may be changing with Allscripts’ renewed commitment and efforts.
Because of the uncertainties they have to deal with, providers want to chose a vendor that is perceived as “safe,” in the way IBM was perceived in the mainframe and minicomputer market 30 years ago. “Some vendors tout their EMR’s mainstream, open architectures, but providers are not thinking of that first,” Buckley says. “They don’t say, ‘I need the best technology.’ They say, ‘I need the best vendor.’”
Harm Scherpbier, M.D., vice president and chief medical information officer at the five-hospital Main Line Health, in the Philadelphia suburbs, agrees with Buckley about the importance of integration. “From an information systems perspective because you have fewer things to manage, and from a clinical perspective because transitions of care are becoming so important, an integrated system is better for that than a best-of-breed system.” Yet even integrated system vendors need to do a good job of interoperability because you are likely to have to exchange data with community vendors who aren’t on the same system, adds Scherpbier, who is on KLAS’ advisory board.
Other vendors are moving in the direction that Epic and Cerner have taken; the question is the speed at which they will get there, Scherpbier notes. “There is always a tendency to lean toward the safe choice and Epic is perceived that way,” he says. “But that comes at a huge price premium, and there could come a point where there is an opportunity for the other vendors to price their products in ways that would help providers see Epic as getting too expensive.”
Each vendor in this space faces its own particular challenges. In the case of Siemens, for example, some integrated components are still maturing and lack functionality, Buckley says. “There is a perception that Siemens could move a lot faster still. Siemens does have integrated ambulatory and ED systems, but providers that have tried them out, have told us while they are glad that Siemens has made the effort, they are not ready for prime time yet.”
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